Zh Nevrol Psikhiatr
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Zh Nevrol Psikhiatr · Jan 2013
Review[Wernicke encephalopathy and Korsakoff's psychosis: clinical-pathophysiological correlation, diagnostics and treatment].
Wernicke's encephalopathy and Korsakoff's psychosis are severe unfavorable forms of alcoholic brain damage with poor prognosis. Thiamine deficiency represents a common cause of both diseases. In many cases, Korsakoff's psychosis develops in the outcome of Wernicke's encephalopathy, which, along with the general etiology, lets talk about a single disease - Wernicke-Korsakoff syndrome, acute (usually reversible) stage of which is Wernicke's encephalopathy and a chronic one (often irreversible) is Korsakoff psychosis. ⋯ Unrecognized and therefore go untreated Wernicke's encephalopathy is a serious threat to the health and lives of patients, worsens the processes of brain aging and increases the risk of Alzheimer's disease in later life. The basic approach to the treatment of Wernicke-Korsakoff syndrome is long-term parenteral administration of thiamine, often in high doses. As an adjuvant means of therapy memantine is considered.
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Zh Nevrol Psikhiatr · Jan 2013
Comparative Study[Delirium in the acute phase of stroke: frequency and predisposing factors].
Delirium is a common complication of stroke worsening its prognosis. In this work we have analyzed the frequency of delirium and factors, predisposing to its development in the population of Russian patients in hyperacute phase of stroke. ⋯ Patients of older age, those with severe stroke, with prominent chronic cerebral changes on brain CAT scan, with fever, those with urine catheter and with positive snout reflex were more likely to develop delirium. Severity of posterior leucoareosis was the only independent predictor of delirium according to multivariate analysis.
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To study pathogenetic features of chronic joint pain, we examined 183 patients with rheumatoid arthritis (RA) and 80 patients with osteoarthrosis (OA). The presence of mixed pain syndrome was found. A neuropathic component of pain (NCP) was observed in some patients with nociceptive pain (43 and 30% with RA and OA, respectively). ⋯ No signs of the damage of the somatosensory nervous system were found in patients with OA. Neuropathic pain was concomitant to secondary hyperalgesia which covered the zones localized far from the affected joint that allowed to suggest the involvement of dysfunctional mechanisms in the pathogenesis of chronic pain in OA. The study opens new possibilities for pharmacotherapy.
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Zh Nevrol Psikhiatr · Jan 2013
Comparative Study[Behavioral dependence on analgesics in medication overuse headache].
Authors conducted a clinical and psychological study in 3 groups of patients: 43 patients with medication overuse headache (MOH), 23 patients with chronic headache without medication overuse and 14 patients with episodic migraine. Along with clinical and neurological examination, the following questionnaires were administered: the McGill questionnaire, the Beck Depression Inventory, the Spielberger-Khanin test, the Toronto alexithymia scale, the Leonhard personality inventory and an inventory based on the Benzodiazepine Dependence Self-Report Questionnaire (BDSRQ). ⋯ It was identified a progressive disease course with a formation of a specific behavioral pattern. Further studies are warranted to understand the reasons for acquiring behavioral dependence on analgetic medications, to improve management and prevent relapses of medication overuse headache.
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Zh Nevrol Psikhiatr · Jan 2013
[Vertebral artery dissection: peculiarities of clinical and magnetic resonance imaging manifestations].
The aim of this study was to analyze clinical and neuroimaging manifestations of vertebral artery (VA) dissection. Twenty seven patients (19 men, 8 women, mean age 34.1±6.1) with the VA dissection were enrolled. All the patients underwent MRA, neck MRI (T1 f-s, T2 f-s) and head MRI. ⋯ Clinical manifestations of VA dissection depend on the IMH localization. The main mechanism of brain ischemia appears to be an arterial embolism by clotted IMH fragments from the secondary intimal tear. It is suggested that in patients with isolated pain, the media may be weaker than in patients with brain ischemia that in turn promotes subadventicial IMH propagation.